Reumatizam, Vol. 63 No. suppl.1, 2016.
Review article
RHEUMATOLOGY IN PEDIATRIC CARDIOLOGY FROM FETAL STAGE TO ADULTHOOD. THE ROLE OF FETAL ECHOCARDIOGRAPHY
Ivan Malčić
Abstract
Even though in the last ten years pediatric cardiology and rheumatology have formally separated in
Croatia as well, strong links still remain between them. Th ey are no longer manifested through rheumatic fever, but
through other rheumatic entities: systemic lupus erythematosus, antiphospholipid syndrome, systemic scleroderma,
Kawasaki disease, polyarteritis nodosa, and some forms of granulomatous vasculitis. We take special note of the occurrence
of complete congenital atrioventricular block (CCAVB) in pregnant women who, due to systemic connective
tissue diseases, develop distinctive ANA antibodies (anti-SSA/Ro and/or anti SSB/La), but who are also likely to have
the same infl ammation within the heart, leading to the development of restricted cardiomyopathy associated with
CCAVC. Although rheumatology has thus been involved with early fetal age for some time now, there are also some
issues relating to the embryonal stage (the association between methotrexate/folic acid and heart development in embryos),
as well as to the late fetal stage (antiprostaglandin anti-infl ammatory agent impact on premature ductus arteriosus
closure). We gave special attention to the neonatal lupus syndrome, the most serious complication in the fetal
period. Th us the multiple association between cardiology and rheumatology in all age groups, from the embryonal and
fetal stage to adulthood, is being realized. Th e aim of this paper is to present some important links and thus further
emphasize the new cooperation between pediatric cardiology and rheumatology from fetal stage to adulthood.
Keywords
Lupus erythematosus, systemic – complications, immunology; Echocardiography; Heart block – congenital, etiology, immunology, therapy, ultrasonography; Fetal heart – immunology, ultrasonography; Ultrasonography, prenatal; Antibodies, antinuclear – immunology; Pregnancy complications – immnunology; Dexamethasone – therapeutic use
Hrčak ID:
182843
URI
Publication date:
19.10.2016.
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